Prussia's gold Rettungsmedaille (Lifesaving Medal) was originally established on 13 August 1833 by King Friedrich Wilhelm III as a silver Lifesaving Medal. The gold version is documented as being awarded as early as 1881. It was awarded to any person who through personal danger had saved another person or who had attempted to and was awarded for combat or non-combat - with no distinction made in the award itself. The gold version was intended for those who had clearly qualified but who were of sufficient social status to warrant a special award at the time of their deed. This series of awards ended in 1924 although is seems that some other Prussian Livesaving awards continued until the 1930.

The Lifesaving Medal is made of various alloys of gold and uses the opposite color ribbon (approximately 30 cm wide, orange with 2 white stripes toward each end - very similar to the 3rd Reich West Wall Medal) as the Order of the Red Eagle. It's interesting to note that the original drawings of the medal specified that it would be of the same dimensions as the Prussian 1 Mark coin. The original issue obverse had KOENIG VON PREUSSEN*FRIEDRICH WILHELM III circling the King's profile. The reverse has changed many times but typically has the name of the medal (FÜR RETTUNG AUS GEFAHR) in raised lettering and has a leaf spray circle. Since it has been issued over a long span of time, there are many variants. It is unknown how many were issued and the WWI records are very sketchy. Almost none have appeared on the market and the majority are in medal groups.